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Antimicrobial Prescribing and Healthcare-Associated Infection Surveillance in the Province of KwaZulu-Natal, South Africa: Findings from The Global-PPS

Tracks
Meeting Room 1.63 - 1.64
Monday, June 30, 2025
12:30 PM - 1:00 PM

Overview

Speaker: Mrs Reshma Misra


Speaker

Mrs Reshma Misra
KZN Department of Health

Antimicrobial Prescribing And Healthcare-Associated Infection Surveillance In The Province Of KwaZulu-Natal, South Africa: Findings From The Global-PPS

Abstract

Background
Infection prevention and control (IPC) and antimicrobial stewardship (AMS) are hindered by limited resources in KwaZulu-Natal. We aimed to monitor antimicrobial prescribing and healthcare-associated infections (HAIs) in hospitals across KwaZulu-Natal to establish a surveillance baseline and enhance patient care.

Methods
We examined validated Point Prevalence Survey data of 49 out of 58 hospitals who participated in the Global-PPS from 2023 till 2024. Data covered all inpatients receiving antimicrobials on the survey day, with all admitted inpatients as denominator (http://www.global-pps.com).

Results
Out of 10,305 patients admitted to 287 wards in 2023–2024, 3,607 (35.0%) received at least one antimicrobial. Prevalence was slightly lower in 2024 (34.2%) than in 2023 (36.2%), with higher rates in child/neonatal wards (46.8%) compared to adult wards (31.8%). HAI prevalence also declined from 6.7% in 2023 to 5.5% in 2024. Among all 3,074 antimicrobials, antibiotics (86.6%), antifungals (5.4%), TB drugs (3.0%), and antivirals (2.9%) were used, with 46.8% prescribed for community-acquired infections and 24.9% for healthcare-associated infections (HAIs). Top antibiotics were amoxicillin/clavulanic acid (21.8%); ceftriaxone (10.1%), cefazolin (6.7%), metronidazole (6.1%).

Conclusions
Despite challenges, with strong leadership from the provincial level and facility teamwork, the Global-PPS was successfully implemented in KwaZulu-Natal. The results help verify patient safety incident reporting quality and assess alignment with Global-PPS data. This data supports policy advocacy, identifies hospitals with high HAI rates for onsite mentorship and guides care bundle prioritization. Daily surveillance of HAIs is now digitalized.

Biography

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